Cannabis Use Patterns Differ by Sexual Identity, Attraction, and Gender

Bisexual women had the highest cannabis use rates, with 2.57 times the odds of both vaping and non-vaping cannabis compared to heterosexual women, while men showed different disparity patterns.

Qin, Weisiyu Abraham et al.·Addictive behaviors·2026·Strong EvidenceCross-Sectional
RTHC-08569Cross SectionalStrong Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Strong Evidence
Sample
N=40,030

What This Study Found

Among women, bisexual identity was linked to the highest odds of cannabis vaping (aOR=2.57) and non-vaping use (aOR=2.57). Women with same-sex or both-sex attraction had higher odds of both use modes. Heterosexual-discordant women (heterosexual identity but non-heterosexual attraction) were also at increased risk. Among men, disparities were more consistently linked to non-vaping cannabis use.

Key Numbers

N=40,030. Bisexual women: aOR=2.57 for both vaping and non-vaping cannabis. Same-sex attracted women had elevated odds of both modes. Men showed disparities primarily in non-vaping use. Analysis adjusted for demographic variables and other substance use.

How They Did This

Analysis of 2022 NSDUH nationally representative data (N=40,030) using weighted multivariable logistic regression examining associations between sexual orientation dimensions and past-30-day cannabis vaping and non-vaping use.

Why This Research Matters

This is the first study to examine cannabis use across multiple dimensions of sexual orientation (identity, attraction, concordance/discordance) and by delivery method. Understanding these nuanced patterns is essential for reducing substance use disparities in sexual minority populations.

The Bigger Picture

Sexual minority stress theory suggests higher substance use in SM populations results from discrimination, stigma, and identity-related stressors. The gender-specific and modality-dependent patterns found here suggest that prevention efforts need to be tailored rather than one-size-fits-all.

What This Study Doesn't Tell Us

Cross-sectional data cannot establish causation. Self-reported sexual orientation and cannabis use. The 2022 NSDUH may not capture all dimensions of sexual orientation. Cannabis vaping and non-vaping categories may overlap in some individuals.

Questions This Raises

  • ?Why do bisexual women show the highest cannabis use rates?
  • ?Do the different use modality patterns between men and women reflect different social contexts or motivations for use?

Trust & Context

Key Stat:
Bisexual women: 2.57x odds of cannabis use
Evidence Grade:
Nationally representative dataset (NSDUH) with strong methodology and large sample, though cross-sectional design limits causal inference.
Study Age:
2026 study analyzing 2022 data.
Original Title:
Cannabis use among sexual minority adults: insights from recent U.S. nationally representative data.
Published In:
Addictive behaviors, 172, 108495 (2026)
Database ID:
RTHC-08569

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Do LGBTQ+ people use more cannabis?

This nationally representative study found sexual minority individuals, particularly bisexual women, had significantly higher cannabis use rates. The patterns varied by gender, specific sexual orientation dimension, and method of use.

Why would sexual orientation affect cannabis use?

Sexual minority stress theory suggests that discrimination, stigma, and identity-related challenges may drive higher substance use rates. The specific patterns differ by gender and sexual orientation dimension.

Read More on RethinkTHC

Cite This Study

RTHC-08569·https://rethinkthc.com/research/RTHC-08569

APA

Qin, Weisiyu Abraham; Elam, Kit K; Lederer, Alyssa M; Seo, Dong-Chul. (2026). Cannabis use among sexual minority adults: insights from recent U.S. nationally representative data.. Addictive behaviors, 172, 108495. https://doi.org/10.1016/j.addbeh.2025.108495

MLA

Qin, Weisiyu Abraham, et al. "Cannabis use among sexual minority adults: insights from recent U.S. nationally representative data.." Addictive behaviors, 2026. https://doi.org/10.1016/j.addbeh.2025.108495

RethinkTHC

RethinkTHC Research Database. "Cannabis use among sexual minority adults: insights from rec..." RTHC-08569. Retrieved from https://rethinkthc.com/research/qin-2026-cannabis-use-among-sexual

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.